A panel study of the acute effects of personal exposure to household air pollution on ambulatory blood pressure in rural Indian women

Norris, Christina; Goldberg, Mark S.; Marshall, Julian; Valois, Marie‐France; Pradeep, T.; Narayanswamy, M.; Jain, Grishma; Shunmugavelu, Karthik; Baumgartner, Jill

doi:10.1016/j.envres.2016.02.024

Cited by 57 publications

(46 citation statements)

References 58 publications

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“…This puts a person exposed to household air pollutants at risk of atherosclerosis, angina, ventricular hypertrophy, hypertension, pulmonary hypertension, ventricular conduction defects, and arrhythmias, leading to increased cardiovascular mortality and gross morbidity 52 . Exposure to biomass fuel smoke has been associated with an acute increase in systolic blood pressure 53 . The burning of incense sticks has been shown to increase the risks of cardiovascular mortality and stroke mortality by 1.12- and 1.19-fold, respectively.…”

Section: Effects Of Household Air Pollutionmentioning

confidence: 99%

Household air pollution and its effects on health

Apte¹,

Salvi²

2016

F1000Res

138

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Household air pollution is a leading cause of disability-adjusted life years in Southeast Asia and the third leading cause of disability-adjusted life years globally. There are at least sixty sources of household air pollution, and these vary from country to country. Indoor tobacco smoking, construction material used in building houses, fuel used for cooking, heating and lighting, use of incense and various forms of mosquito repellents, use of pesticides and chemicals used for cleaning at home, and use of artificial fragrances are some of the various sources that contribute to household air pollution. Household air pollution affects all stages of life with multi-systemic health effects, and its effects are evident right from pre-conception to old age. In utero exposure to household air pollutants has been shown to have health effects which resonate over the entire lifetime. Exposures to indoor air pollutants in early childhood also tend to have repercussions throughout life. The respiratory system bears the maximum brunt, but effects on the cardiovascular system, endocrine system, and nervous system are largely underplayed. Household air pollutants have also been implicated in the development of various types of cancers. Identifying household air pollutants and their health implications helps us prepare for various health-related issues. However, the real challenge is adopting changes to reduce the health effects of household air pollution and designing innovative interventions to minimize the risk of further exposure. This review is an attempt to understand the various sources of household air pollution, the effects on health, and strategies to deal with this emergent risk factor of global mortality and morbidity.

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Section: Effects Of Household Air Pollutionmentioning

confidence: 99%

Household air pollution and its effects on health

Apte¹,

Salvi²

2016

F1000Res

138

View full text Add to dashboard Cite

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“…Many studies employed relatively crude indicators of exposure to HAP, for example “ever” use of biomass fuel over the life course [3, 14], or current use of solid fuel [11]. Fewer studies actually measured pollutants in locations such as kitchens and living areas or using personal exposure monitoring [9, 10, 12, 16, 17]. …”

Section: Introductionmentioning

confidence: 99%

“…Despite its clear clinical potential, ABPM is relatively underutilized in low and middle income countries [29]. One study has reported using ABPM to measure BP in association with HAP exposure in India; this study investigated associations during cooking sessions only and was inconclusive in its findings [10]. We know of no studies that have reported on the feasibility of ABPM in a rural African setting.…”

Section: Introductionmentioning

confidence: 99%

Ambulatory monitoring demonstrates an acute association between cookstove-related carbon monoxide and blood pressure in a Ghanaian cohort

et al. 2017

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BackgroundRepeated exposure to household air pollution may intermittently raise blood pressure (BP) and affect cardiovascular outcomes. We investigated whether hourly carbon monoxide (CO) exposures were associated with acute increases in ambulatory blood pressure (ABP); and secondarily, if switching to an improved cookstove was associated with BP changes. We also evaluated the feasibility of using 24-h ambulatory blood pressure monitoring (ABPM) in a cohort of pregnant women in Ghana.MethodsParticipants were 44 women enrolled in the Ghana Randomized Air Pollution and Health Study (GRAPHS). For 27 of the women, BP was measured using 24-h ABPM; home blood pressure monitoring (HBPM) was used to measure BP in the remaining 17 women. Personal CO exposure monitoring was conducted alongside the BP monitoring.ResultsABPM revealed that peak CO exposure (defined as ≥4.1 ppm) in the 2 hours prior to BP measurement was associated with elevations in hourly systolic BP (4.3 mmHg [95% CI: 1.1, 7.4]) and diastolic BP (4.5 mmHg [95% CI: 1.9, 7.2]), as compared to BP following lower CO exposures. Women receiving improved cookstoves had lower post-intervention SBP (within-subject change in SBP of −2.1 mmHg [95% CI: -6.6, 2.4] as compared to control), though this result did not reach statistical significance. 98.1% of expected 24-h ABPM sessions were successfully completed, with 92.5% of them valid according to internationally defined criteria.ConclusionsWe demonstrate an association between acute exposure to carbon monoxide and transient increases in BP in a West African setting. ABPM shows promise as an outcome measure for assessing cardiovascular health benefits of cookstove interventions.Trial registrationThe GRAPHS trial was registered with clinicaltrials.gov on 13 April 2011 with the identifier NCT01335490.Electronic supplementary materialThe online version of this article (doi:10.1186/s12940-017-0282-9) contains supplementary material, which is available to authorized users.

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“…Additionally, observational studies conducted in women in villages in eastern India observed increased pro-inflammatory cytokines, higher serum c-reactive protein, and higher reactive oxygen species generation in the women exposed to biomass fuel smoke 97 . Another study of women in rural India observed an increase in systolic blood pressure during cooking times during which there was also an increase in exposure to the air pollutant black carbon, a major component of soot 98 . Additional research on the acute biochemical and physiologic response to household air pollution from biomass fuel combustion is needed to better understand how this exposure differs from ambient air pollution.…”

Section: Household Air Pollution From Biomass Fuel Usementioning

confidence: 99%

Environmental Exposures and Cardiovascular Disease

2017

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Summary Environmental exposures in low- and middle-income countries lie at the intersection of increased economic development and the rising public health burden of cardiovascular disease. Increasing evidence suggests an association of exposure to ambient air pollution, household air pollution from biomass fuel, lead, arsenic, and cadmium with multiple cardiovascular disease outcomes including hypertension, coronary heart disease, stroke, and cardiovascular mortality. While populations in low- and middle-income countries are disproportionately exposed to environmental pollution, the bulk of evidence that links these exposures to cardiovascular disease is derived from populations in high-income countries. More research is needed to further characterize the extent of environmental exposures and develop targeted interventions towards reducing cardiovascular disease in at-risk populations in low- and middle-income countries.

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A panel study of the acute effects of personal exposure to household air pollution on ambulatory blood pressure in rural Indian women

Cited by 57 publications

References 58 publications

Household air pollution and its effects on health

Household air pollution and its effects on health

Ambulatory monitoring demonstrates an acute association between cookstove-related carbon monoxide and blood pressure in a Ghanaian cohort

Environmental Exposures and Cardiovascular Disease

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